title: Engineering youth service system infrastructure: Hawaii's continued efforts at large-scale implementation through knowledge management strategies.
abstract: Hawaii's Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaii's mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the system's infrastructure.
authors.affiliation: a Department of Psychology , The University of Hawaii at Manoa.
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Nakamura
authors.forename: Charles W
authors.initials: CW
authors.lastname: Mueller
authors.forename: Charmaine
authors.initials: C
authors.lastname: Higa-McMillan
authors.forename: Kelsie H
authors.initials: KH
authors.lastname: Okamura
authors.forename: Jaime P
authors.initials: JP
authors.lastname: Chang
authors.forename: Lesley
authors.initials: L
authors.lastname: Slavin
authors.forename: Scott
authors.initials: S
authors.lastname: Shimabukuro
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D002648:Child; D003695:Delivery of Health Care / Q000458:organization & administration*; D004059:Diffusion of Innovation; D006254:Hawaii; D006266:Health Education / Q000379:methods; D006801:Humans; D058436:Knowledge Management; D009313:National Health Programs / Q000458:organization & administration*; D011320:Primary Health Care / Q000592:standards*; D016730:Program Development